Healthcare Provider Details

I. General information

NPI: 1316924798
Provider Name (Legal Business Name): SALEM K DAVID JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/28/2005
Last Update Date: 01/26/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1224 MCFARLAND BLVD NE SUITE A
TUSCALOOSA AL
35406-2287
US

IV. Provider business mailing address

1224 MCFARLAND BLVD NE SUITE A
TUSCALOOSA AL
35406-2287
US

V. Phone/Fax

Practice location:
  • Phone: 205-759-9930
  • Fax: 205-759-9931
Mailing address:
  • Phone: 205-759-9930
  • Fax: 205-759-9931

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YX0905X
TaxonomyOtolaryngology/Facial Plastic Surgery Physician
License Number17829
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: